Eating Disorders

Question 1

What are the lifetime prevalences of anorexia nervosa, bulimia nervosa, and binge eating disorder? When is the peak period of risk for developing an eating disorder?

Answer 1

women: 0.9%, 1.5%, 3.5%
men: 0.3%, 0.5%, 2.0%
- mid- to late-adolescence is the peak period for developing an eating disorder

Question 2

What % of youth endorse eating disorder thought patterns and behaviours?

Answer 2

15-47%

Question 3

Which eating disorder has the highest mortality rate of any psychiatric illness? Why?

Answer 3

Anorexia nervosa

• 10% of people with anorexia nervosa die within 10yrs of the onset of the disorder
• 20-25 year life expectancy reduction

Question 4

What is body image and why is it an important concept for eating disorders?

Answer 4

• how people see, think, feel, and act towards their bodies
• people with eating disorders have clinically different perceptions, feelings, thoughts and behaviours towards their body compared to those without the disorder

Question 5

What are the core features of eating disorders?

Answer 5

• persistent disturbance of eating or eating related behaviours, resulting in alterations in consumption of food
• changed eating behaviours which impact health and functioning

Question 6

List the diagnostic criteria for Anorexia Nervosa

Answer 6

• persists over a period of at least 3 months
• persistent behaviours that interfere with maintaining an adequate weight for health (restricting food, purging, misuse of medication, compensating for food through intense exercise)
• powerful fear of weight gain or becoming fat
• overestimations of body size
• denial of seriousness of one’s condition

Question 7

List the diagnostic criteria for Bulimia Nervosa

Answer 7

• cycle of behaviours occur at least once a week over a period of at least 3 months
• recurring episodes of food restriction followed by binge eating
• recurring behaviours that follow bingeing (purging)
• negatively evaluates body weight and shape and tends to value these more than anything else
• experience shame about their binging and purging and may go to great lengths to hide behaviours

Question 8

List the diagnostic criteria for Binge Eating Disorder

Answer 8

• bingeing episodes occur at least once a week for 3 months or more
• consumption of unusually large amounts of food during a short period of time (feeling out of control over what is eaten, quantity consumed, and when to stop)
• NOT followed by compensating behaviours such as excessive exercise, self-induced vomiting, or misuse of laxatives

Question 9

Overeating vs bingeing

Answer 9

overeating = consuming more food than the body needs at a given time

Question 10

Avoidant/Restrictive Food Intake Disorder (ARFID)

Answer 10

• starts in infancy or childhood
• avoidance of foods with certain textures or colours or particular types of food
• possibly derived from traumatic experiences with food
• nutrition and energy requirements not met
• can lead to anorexia nervosa or bulimia nervosa if untreated

Question 11

Rumination Disorder

Answer 11

• consistent regurgitation of chewed or partially digested food
• continues over a period of at least 3 months
• swallowed food is brought up into mouth effortlessly (no gagging, nausea)
• rumination can be symptom of anorexia or bulimia

Question 12

Pica

Answer 12

• persistent consumption of non-food items (soap, paint, paper)
• continues over a period of at least 3 months

Question 13

Other Specified Feeding or Eating Disorder (OSFED)

Answer 13

1. Atypical anorexia nervosa
   - same as anorexia nervosa BUT weight is within or above “average” range for age and height
2. bulimia nervosa (low frequency)
   - same as bulimia nervosa, BUT cycles are occur less frequently than once per week
3. purging disorder
   - persistent purging behaviours without binge eating episodes
4. Night Eating Syndrome
   - excessive consumption of food following and evening meal or after waking in the night
   - extreme psychological distress and disrupts daily functioning

Question 14

What are 3 symptoms/disorders that are not recognized by the DSM?

Answer 14

1. Anorexia athletica (compulsive exercising)
2. orthorexia
3. body dysmorphic disorder

Question 15

Describe Anorexia Athletica

Answer 15

• compulsive exercising
• over exercising to the point that fulfilling their exercise goals takes on more importance than almost anything else in their lives
• unwilling to miss a workout
• taking time off work, school, and relationships to exercise
• focussing on the challenge of exercising instead of enjoyment
• believing one’s self-worth depends on physical performance
• rarely satisfied with physical achievements
• common among athletes and olympians (controversial)

Question 16

Describe Orthorexia

Answer 16

• food and weight related symptoms
  1. eating only food regarded as “healthy”
  2. relying only on “natural” products to treat illness
  3. finding pleasure in eating “correctly” rather than enjoying taste and textures of food

Question 17

Body Dysmorphic Disorder

Answer 17

• preoccupied with appearance with non-existent or slight flaws in physical appearance
• repetitive behaviours (mirror checking, skin pricking, changing clothes)
• impairs daily functioning
• can be diagnosing in conjunction with eating disorder

Question 18

How is treatment administered for eating disorders?

Answer 18

• often multi-disciplinary: involves multiple healthcare workers - nurses, dieticians, physicians, psychologists
• multimodel: involves number of diff. therapies

Question 19

What types of therapy are used?

Answer 19

• CBT, psychoanalysis, nutritional education, equine therapy

Question 20

What 2 issues does treatment aim to address?

Answer 20

1. physiological/somatic symptoms

2. psychological symptoms

Question 21

How are physiological/somatic symptoms addressed? What is the aim?

Answer 21

• by normalizing eating through learning how to eat without dieting and education about the consequences and effects of eating disordered behaviours
• aim: return to healthy weight among other things (weight gain is challenging b/c people fear the idea of gaining weight)

Question 22

How are psychological symptoms addressed?

Answer 22

• psychological therapy by focusing on the cause of one’s eating disorder behaviours and acknowledging and promoting body appreciation and acceptance

Question 23

What are some problems with treatment?

Answer 23

• available treatment methods are heavily focused on the main eating disorders (fewer options for other clinical disorders not recognized by DSM)
• some treatment programs require specific criteria to be met (some people cannot access this)

Question 24

What are the 6 risk factors for eating disorders?

Answer 24

1. Class and Culture
2. Internalization of the Ideal
3. Social Media
4. Sport Pressure
5. Gender Identity and Sexuality
6. Environmental Factors

Question 25

Internalization of the Ideal

Answer 25

• body dissatisfaction and internalization of socialized ideals of appearance are a risk factor
• discrepancy between body shape and body ideals and actually being able to achieve these ideals is likely driving body dissatisfaction

Question 26

Class and Culture

Answer 26

• no matter the culture, place, and space, an individual is likely to develop an eating disorder if they internalize Western cultural and class ideals of thinness and body image

Question 27

Gender Identity and Sexuality

Answer 27

• women are more likely to be diagnosed
• gender role endorsement (extent to which an individual closely identifies with gender norms) may underly the increased rates in women

Question 28

Social Media

Answer 28

• promotes unrealistic body images, especially when individual perceives them to be real and uses them for comparison

Question 29

Sports Pressure

Answer 29

• emphasizing appearance, size, low-body weight and shape/build as being critical for performance can lead to preoccupation with weight and shape

Question 30

Environmental Factors

Answer 30

• child maltreatment, parental pressure and peer pressure are environmental factors associated with eating disorders

Question 31

What are some controversies in the fashion industry?

Answer 31

• in some countries, there are laws that ban underweight models and require labels on images that have been manipulated
• some argue this isn’t enough to change the industry, while others say it’s a step in the right direction

Question 32

What are some controversies in the food industry movement?

Answer 32

• in Canada, there are policies to include calorie counts on restaurant menus (means to combat obesity epidemic)
• some argue this may unintentionally increase people’s preoccupation with calories
• goes against body image movement

Question 33

What are the pros and cons of social media?

Answer 33

pros:
- provides platform for people with eating disorders to share their stories
- used to promote positive body image
cons:
- aids in the maintenance of eating-disordered behaviour

Question 34

How does the Pro-and Movement have a negative effect on social media?

Answer 34

• involves blogs, websites, and chat forums that support eating disordered behavioural practices
• presents themselves as “educational” and are geared towards those recovering from eating disorders

Question 35

how does Fitspiration have a negative effect on social media?

Answer 35

• although its promotes strength and empowerment over thinness, the images on the site are predominantly focused on a particular part of the body and appear to be making “sexy” poses
• promotes symptoms associated with eating disordered behaviour

Question 36

What are 2 core concepts in the Positive Body Image Movement?

Answer 36

1. body appreciation
   - bodies are more than appearance, there is also function and health
2. building media literacy
   - understanding that images in media are often manipulated and fabricated